Occlusion clip

ABSTRACT

An occlusion clip comprising: (a) a spring; (b) a first runner including a first open top and a first open end adjacent the first open top, the first runner including a first interior camming surface partially delineating a first interior cavity that is open by way of the first open top and the first open end; (c) a second runner including a second open top and a second open end adjacent the second open top, the second runner including a second interior camming surface partially delineating a second interior cavity that is open by way of the second open top and the second open end, where the spring is configured to be coupled to the first runner and the second runner, where the first interior cavity is configured to receive a first portion of the spring, where the second interior cavity is configured to receive a second portion of the spring, where the first camming surface is configured to engage a first cam of the spring, and where the second camming surface is configured to engage a second cam of the spring.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of U.S. Provisional PatentApplication Ser. No. 61/906,924, entitled, “OCCLUSION CLIP,” filed Nov.21, 2013, the disclosure of which is incorporated herein by reference.

RELATED ART Field of the Invention

The present invention is directed to occlusion clips and, morespecifically, to open ended clips capable of occluding bodily tissue.

Brief Discussion of Related Art

Embolic stroke is the nation's third leading killer for adults. Embolicstroke is also a major cause of disability. The most common cause ofembolic stroke is thrombus formation in the left appendage of theatrium. In almost all atrial fibrillation (AF) patients suffering fromembolic stroke, a thrombus clot forms in the appendage of the leftatrium.

The primary therapy for the prevention of stroke in AF patients is theadministration of oral anticoagulants. Although somewhat effective,there are numerous side effects, including bleeding and lifestylecompromises.

Another therapy for the prevention of stroke in AF patients is theintroduction of biomaterials into the left atrial appendage to plug theappendage. But these materials may break down over time and allow for acavity of sufficient size to foster clot formation.

Still another approach involves open chest and thoroscopic surgicalprocedures to remove or oversew the left atrial appendage.Alternatively, a percutaneous endocardial approach may be utilized toisolate the left atrial appendage from the inside of the heart. By wayof example, a barrier or other device is anchored in the chamber of theleft atrial appendage to prevent the passage of blood into and out ofthe chamber and thereby prevent clot formation. But, again, the barriermay break down and result in clotting.

Endoscopic stapling devices, suture loops tied to the base of theappendage, and clips pinching the appendage from the outside surface tothe base to close the appendage are used by physicians to isolate andremove the left atrial appendage. In the case of a clip, this clip maybe applied outside of the heart at the base of the appendage.

INTRODUCTION TO THE INVENTION

It is a first aspect of the present invention to provide an occlusionclip comprising: (a) a spring; (b) a first runner including a first opentop and a first open end adjacent the first open top, the first runnerincluding a first interior camming surface partially delineating a firstinterior cavity that is open by way of the first open top and the firstopen end; (c) a second runner including a second open top and a secondopen end adjacent the second open top, the second runner including asecond interior camming surface partially delineating a second interiorcavity that is open by way of the second open top and the second openend, where the spring is configured to be coupled to the first runnerand the second runner, where the first interior cavity is configured toreceive a first portion of the spring, where the second interior cavityis configured to receive a second portion of the spring, where the firstcamming surface is configured to engage a first cam of the spring, andwhere the second camming surface is configured to engage a second cam ofthe spring.

In a more detailed embodiment of the first aspect, at least one of thefirst runner and the second runner is pivotally mounted to the spring.In yet another more detailed embodiment, the first runner and the secondrunner are pivotally mounted to the spring. In a further detailedembodiment, the spring is configured to be removably coupled to at leastone of the first runner and the second runner. In still a furtherdetailed embodiment, the occlusion clip further includes arepositionable lock configured to fixedly mount at least one of thefirst runner and the second runner to the spring. In a more detailedembodiment, the repositionable lock includes a dowel received within anorifice associated with at least one of the spring, the first runner,and the second runner, the spring includes a first arm and a second arm,the first arm includes the first cam, and the second arm includes thesecond cam. In a more detailed embodiment, the repositionable lockincludes a dowel received within an orifice associated with the firstrunner. In another more detailed embodiment, the repositionable lockincludes a dowel received within an orifice associated with the firstrunner and the spring. In yet another more detailed embodiment, therepositionable lock includes a first dowel received within a firstorifice associated with at least one of the first runner and the spring,and the repositionable lock includes a second dowel received within asecond orifice associated with at least one of the second runner and thespring. In still another more detailed embodiment, the repositionablelock includes a third dowel received within a third orifice associatedwith at least one of the second runner and the spring.

In yet another more detailed embodiment of the first aspect, therepositionable lock is configured to allow pivotal movement between thespring and the first runner, and the repositionable lock is configuredto inhibit at least one of rotational movement and longitudinal slidingmovement between the spring and second runner. In yet another moredetailed embodiment, the spring embodies a C-shape with a first leg anda second leg, and at least one of the first leg and the second legincludes a longitudinal variance. In a further detailed embodiment, thefirst leg and the second leg each include a longitudinal variance, andthe longitudinal variance of the first leg forms a cavity along alongitudinal length of the first leg. In still a further detailedembodiment, the longitudinal variance of the second leg forms at leasttwo cavities along a longitudinal length of the first leg. In a moredetailed embodiment, the longitudinal variance of the first leg isconfigured to receive a first portion of the repositionable lock tomount the first leg to the first runner, and the longitudinal varianceof the second leg is configured to receive a second portion and a thirdportion of the repositionable lock to mount the second leg to the secondrunner. In a more detailed embodiment, the longitudinal variance of thefirst leg comprises a first V-shaped notch, the longitudinal variance ofthe second leg comprises a second V-shaped notch and a third V-shapednotch, the first portion includes a first dowel, the second portionincludes a second dowel, and the third portion includes a third dowel.In another more detailed embodiment, the first runner includes anarcuate tissue contacting surface, and the second runner includes anarcuate tissue contacting surface, the arcuate tissue contacting surfaceof the first runner faces the arcuate tissue contacting surface of thesecond runner when the first and second runners are mounted to thespring. In yet another more detailed embodiment, the occlusion clipfurther includes a first repositionable lock configured to fixedly mountthe first runner to the spring, and a second repositionable lockconfigured to fixedly mount the second runner to the spring. In stillanother more detailed embodiment, the first runner includes at least oneof a depression and an orifice configured to receive a portion of thefirst repositionable lock, and the second runner includes at least oneof a depression and an orifice configured to receive a portion of thesecond repositionable lock.

In a more detailed embodiment of the first aspect, the first runnerincludes an orifice configured to receive a portion of the firstrepositionable lock, and the second runner includes an orificeconfigured to receive a portion of the second repositionable lock. Inyet another more detailed embodiment, the orifice of the first runnerincludes a first pair of orifices, the orifice of the second runnerincludes a second pair of orifices, the first repositionable lockincludes a first dowel configured to be received by the first pair oforifices of the first runner, and the second repositionable lockincludes a second dowel configured to be received by the second pair oforifices of the second runner. In a further detailed embodiment, thespring embodies a C-shape with a first leg and a second leg, the firstleg includes at least one of a cavity and an orifice configured toreceive a first repositionable lock operative to mount the first leg tothe first runner, and the second leg includes at least one of a cavityand an orifice configured to receive a second repositionable lockoperative to mount the second leg to the second runner. In still afurther detailed embodiment, a distal end of the first leg includes thefirst camming surface, a distal end of the second leg includes thesecond camming surface, the distal end of the first leg includes acavity configured to receive a first repositionable lock operative tomount the first leg to the first runner, and the distal end of thesecond leg includes a cavity configured to receive a secondrepositionable lock operative to mount the second leg to the secondrunner. In a more detailed embodiment, the first runner includes atleast one of a first runner cavity and a first runner orifice configuredto receive a portion of the first repositionable lock, and the secondrunner includes at least one of a second runner cavity and a secondrunner orifice configured to receive a portion of the secondrepositionable lock. In a more detailed embodiment, the first runnerincludes a first runner orifice, the second runner includes a secondrunner orifice, the first repositionable lock comprises a first dowelconfigured to be concurrently received within the first runner orificeand the cavity of the first leg to mount the first leg to the firstrunner, and the second repositionable lock comprises a second dowelconfigured to be concurrently received within the second runner orificeand the cavity of the second leg to mount the second leg to the secondrunner. In another more detailed embodiment, a distal end of the firstleg includes the first camming surface, a distal end of the second legincludes the second camming surface, the distal end of the first legincludes an orifice configured to receive a first repositionable lockoperative to mount the first leg to the first runner, and the distal endof the second leg includes an orifice configured to receive a secondrepositionable lock operative to mount the second leg to the secondrunner. In yet another more detailed embodiment, the first runnerincludes at least one of a first runner cavity and a first runnerorifice configured to receive a portion of the first repositionablelock, and the second runner includes at least one of a second runnercavity and a second runner orifice configured to receive a portion ofthe second repositionable lock. In still another more detailedembodiment, the first runner includes a first runner orifice, the secondrunner includes a second runner orifice, the first repositionable lockcomprises a first dowel configured to be concurrently received withinthe first runner orifice and the orifice of the first leg to mount thefirst leg to the first runner, and the second repositionable lockcomprises a second dowel configured to be concurrently received withinthe second runner orifice and the orifice of the second leg to mount thesecond leg to the second runner.

In yet another more detailed embodiment of the first aspect, theocclusion clip further includes a first repositionable lock configuredto fixedly mount the first runner to the spring, and a secondrepositionable lock configured to fixedly mount the second runner to thespring, wherein the spring embodies a C-shape with a first leg and asecond leg, the first leg includes at least one of a cavity and anorifice configured to receive at least a portion of the firstrepositionable lock, the second leg includes at least one of a cavityand an orifice configured to receive at least a portion of the secondrepositionable lock, and at least one of the cavity and the orifice ofthe first leg is longitudinally offset from the at least one of thecavity and the orifice of the second leg. In yet another more detailedembodiment, the first leg includes a projection extending toward thesecond leg, and at least one of the cavity and the orifice of the secondleg longitudinally interposes the projection and at least one of thecavity and the orifice of the first leg. In a further detailedembodiment, the first leg includes a cavity configured to receive atleast a portion of the first repositionable lock, the second legincludes a cavity configured to receive at least a portion of the secondrepositionable lock, and the cavity of the second leg longitudinallyinterposes the projection and the cavity of the first leg. In still afurther detailed embodiment, the first leg includes an orificeconfigured to receive at least a portion of the first repositionablelock, the second leg includes an orifice configured to receive at leasta portion of the second repositionable lock, and the orifice of thesecond leg longitudinally interposes the projection and the orifice ofthe first leg. In a more detailed embodiment, the occlusion clip furtherincludes a first repositionable lock configured to fixedly mount thefirst runner to the spring, and a second repositionable lock configuredto fixedly mount the second runner to the spring, where the springembodies a C-shape with a first leg and a second leg, the first legincludes at least one of a cavity and an orifice configured to receiveat least a portion of the first repositionable lock, the second legincludes at least one of a cavity and an orifice configured to receiveat least a portion of the second repositionable lock, and the springincludes a first ancillary leg interposing the first leg and the secondleg. In a more detailed embodiment, the first leg includes a cavityconfigured to receive at least a portion of the first repositionablelock, the second leg includes a cavity configured to receive at least aportion of the second repositionable lock, and the cavity of the secondleg longitudinally interposes the projection and the cavity of the firstleg. In another more detailed embodiment, the first leg includes anorifice configured to receive at least a portion of the firstrepositionable lock, the second leg includes an orifice configured toreceive at least a portion of the second repositionable lock, and theorifice of the second leg longitudinally interposes the projection andthe orifice of the first leg. In yet another more detailed embodiment,the first ancillary leg is configured to engage the first runner withoutbeing fixedly attached to the first runner.

In a more detailed embodiment of the first aspect, the occlusion clipfurther includes a first repositionable lock configured to fixedly mountthe first runner to the spring, and a second repositionable lockconfigured to fixedly mount the second runner to the spring, where thespring embodies a C-shape with a first leg and a second leg, the firstleg includes at least one of a cavity and an orifice configured toreceive at least a portion of the first repositionable lock, the secondleg includes at least one of a cavity and an orifice configured toreceive at least a portion of the second repositionable lock, and thespring includes a first ancillary leg and a second ancillary leg. In yetanother more detailed embodiment, the first leg includes a cavityconfigured to receive at least a portion of the first repositionablelock, the second leg includes a cavity configured to receive at least aportion of the second repositionable lock, and the cavity of the secondleg longitudinally interposes the projection and the cavity of the firstleg. In a further detailed embodiment, the first leg includes an orificeconfigured to receive at least a portion of the first repositionablelock, the second leg includes an orifice configured to receive at leasta portion of the second repositionable lock, and the orifice of thesecond leg longitudinally interposes the projection and the orifice ofthe first leg. In still a further detailed embodiment, the firstancillary leg extends longitudinally between the first leg and thesecond leg, the second ancillary leg extends longitudinally between thefirst leg and the second leg, the first ancillary leg interpose thefirst leg and the second ancillary leg, and the second ancillary leginterpose the second leg and the first ancillary leg. In a more detailedembodiment, the first ancillary leg is configured to engage the firstrunner without being fixedly attached to the first runner, and thesecond ancillary leg is configured to engage the second runner withoutbeing fixedly attached to the second runner. In a more detailedembodiment, the first ancillary leg comprises a first pair of ancillarylegs, the second ancillary leg comprises a second pair of ancillarylegs, the first leg interposes the first pair of ancillary legs, and thesecond leg interposes the second pair of ancillary legs. In another moredetailed embodiment, the first pair of ancillary legs is configured toengage the first runner without being fixedly attached to the firstrunner, and the second pair of ancillary legs is configured to engagethe second runner without being fixedly attached to the second runner.

In yet another more detailed embodiment of the first aspect, theocclusion clip further includes a wedge removably coupled to the springproximate a living hinge of the spring, where the spring includes afirst leg and a first ancillary leg on a first side of the living hinge,the spring includes a second leg and a second ancillary leg on a secondside of the living hinge, and the wedge is operative, when coupled tothe spring, to change a force necessary to increase a separation betweenthe first leg and the second leg. In yet another more detailedembodiment, the first ancillary leg extends longitudinally between thefirst leg and the second leg, the second ancillary leg extendslongitudinally between the first leg and the second leg, the firstancillary leg interpose the first leg and the second ancillary leg, andthe second ancillary leg interpose the second leg and the firstancillary leg. In a further detailed embodiment, the first ancillary legis configured to engage the first runner without being fixedly attachedto the first runner, and the second ancillary leg is configured toengage the second runner without being fixedly attached to the secondrunner. In still a further detailed embodiment, the first ancillary legcomprises a first pair of ancillary legs, the second ancillary legcomprises a second pair of ancillary legs, the first leg interposes thefirst pair of ancillary legs, and the second leg interposes the secondpair of ancillary legs. In a more detailed embodiment, the first pair ofancillary legs is configured to engage the first runner without beingfixedly attached to the first runner, and the second pair of ancillarylegs is configured to engage the second runner without being fixedlyattached to the second runner. In a more detailed embodiment, theocclusion clip further includes a fabric interposing the first andsecond runners. In another more detailed embodiment, the occlusion clipfurther includes a C-shaped fabric sleeve encapsulating the occlusionclip.

It is a second aspect of the present invention to provide an occlusionclamp comprising: (a) a spring comprising at least two elongated legscoupled together at a first end and independently repositionable withrespect to one another at second, free ends so that the spring isopen-ended, the spring having a dominant dimension measured from thefirst end to one of the second ends; (b) a first runner coupled to afirst leg of the at least two elongated legs, the first runnercomprising an elongated occlusion beam having an occlusion surface, thefirst runner having a dominant dimension; (c) a second runner coupled toa second leg of the at least two elongated legs, the second runnercomprising an elongated occlusion beam having an occlusion surface, thesecond runner having a dominant dimension, where the spring isconfigured to bias the occlusion surface of the first runner toward theocclusion surface of the second runner, and where the dominantdimensions of the spring, first runner, and the second runner extend ingenerally the same direction.

In a more detailed embodiment of the second aspect, the second, freeends are spaced apart from one another along the dominant dimension ofthe spring, the first leg is coupled to the first runner at a firstlocation, the second leg is coupled to the second runner at a secondlocation and a third location, and the first location interposes thesecond and third locations along the dominant dimension. In yet anothermore detailed embodiment, the first leg traps a first pin to mount thefirst leg to the first runner, and the second leg traps a second pin anda third pin to mount the second leg to the second runner. In a furtherdetailed embodiment, the first pin is mounted to the first runner, thesecond pin and the third pin are mounted to the second runner, the firstleg includes a first discontinuity configured to receive the first pinso that the first leg interposes the first pin and the first runner tomount the first leg to the first runner, and the second leg includes asecond discontinuity configured to receive the second pin and a thirddiscontinuity configured to receive the third pin so that the second leginterposes the second pin and the second runner and interposes the thirdpin and the second runner to mount the second leg to the second runner.In still a further detailed embodiment, the first discontinuitycomprises at least one of a U-shaped segment and a V-shaped segment, thesecond discontinuity comprises at least one of a U-shaped segment and aV-shaped segment, and the third discontinuity comprises at least one ofa U-shaped segment and a V-shaped segment. In a more detailedembodiment, the first discontinuity is received within a trench of thefirst runner, and the second discontinuity and the third discontinuityare received within a trench of the second runner. In a more detailedembodiment, the spring includes at least one of a rectangular, circular,or oblong cross-section. In another more detailed embodiment, thesecond, free ends are spaced apart from one another along the dominantdimension of the spring, the first leg is coupled to the first runner ata first location, the second leg is coupled to the second runner at asecond location and contacts the second runner at a third location, andthe first location interposes the second and third locations along thedominant dimension. In yet another more detailed embodiment, a first pinis mounted to the first runner, a second pin is mounted to the secondrunner, the first leg traps the first pin to mount the first leg to thefirst runner, and the second leg traps the second pin to mount thesecond leg to the second runner. In still another more detailedembodiment, the first leg includes a first discontinuity configured toreceive the first pin so that the first leg interposes the first pin andthe first runner to mount the first leg to the first runner, and thesecond leg includes a second discontinuity configured to receive thesecond pin so that the second leg interposes the second pin and thesecond runner to mount the second leg to the second runner.

In yet another more detailed embodiment of the second aspect, the firstdiscontinuity comprises at least one of a U-shaped segment and aV-shaped segment, and the second discontinuity comprises at least one ofa U-shaped segment and a V-shaped segment. In yet another more detailedembodiment, the first discontinuity is received within a trench of thefirst runner, the second discontinuity is received within a trench ofthe second runner, the second leg includes a third discontinuity that isreceived within the trench of the second runner, and the thirddiscontinuity occurs at the third location. In a further detailedembodiment, the spring further comprises a third leg mounted to at leastone of the first leg and the second leg. In still a further detailedembodiment, the first leg is coupled to the first runner at a firstlocation, the second leg is coupled to the second runner at a secondlocation, and the first location is approximately the same as the secondlocation along the dominant dimension. In a more detailed embodiment, afirst pin is mounted to the first runner, a second pin is mounted to thesecond runner, the first leg traps the first pin to mount the first legto the first runner, and the second leg traps the second pin to mountthe second leg to the second runner. In a more detailed embodiment, thefirst leg includes a first orifice configured to receive the first pinso that the first leg interposes the first pin and the first runner tomount the first leg to the first runner, and the second leg includes asecond orifice configured to receive the second pin so that the secondleg interposes the second pin and the second runner to mount the secondleg to the second runner. In another more detailed embodiment, the firstorifice is at least partially received within a trench of the firstrunner, and the second orifice is at least partially received within atrench of the second runner. In yet another more detailed embodiment,the first and second legs delineate a U-shaped primary spring, and thethird leg interposes the first and second legs. In still another moredetailed embodiment, the third leg extends from a trough cooperativelyformed by the intersection of the first and second legs, and the thirdleg comprises a partial U-shaped secondary spring.

In a more detailed embodiment of the second aspect, the spring furthercomprises a third leg mounted to at least one of the first leg and thesecond leg, and the spring further comprises a fourth leg mounted to atleast one of the first leg and the second leg. In yet another moredetailed embodiment, the first leg is coupled to the first runner at afirst location, the second leg is coupled to the second runner at asecond location, and the first location is approximately the same as thesecond location along the dominant dimension. In a further detailedembodiment, a first pin is mounted to the first runner, a second pin ismounted to the second runner, the first leg traps the first pin to mountthe first leg to the first runner, and the second leg traps the secondpin to mount the second leg to the second runner. In still a furtherdetailed embodiment, the first leg includes a first orifice configuredto receive the first pin so that the first leg interposes the first pinand the first runner to mount the first leg to the first runner, and thesecond leg includes a second orifice configured to receive the secondpin so that the second leg interposes the second pin and the secondrunner to mount the second leg to the second runner. In a more detailedembodiment, the first orifice is at least partially received within atrench of the first runner, and the second orifice is at least partiallyreceived within a trench of the second runner. In a more detailedembodiment, the first and second legs delineate a U-shaped primaryspring, the third leg interposes the first and second legs, and thefourth leg interposes the first and second legs. In another moredetailed embodiment, the third and fourth legs extend from a troughcooperatively formed by the intersection of the first and second legs,and the third and fourth legs cooperate to delineate a U-shapedsecondary spring.

In a more detailed embodiment of the second aspect, the first and secondlegs comprise a primary spring, the third leg interposes the first andsecond legs, and the fourth leg interposes the first and second legs. Inyet another more detailed embodiment, the third and fourth legs extendfrom the first end, the first end includes a cavity opposite the thirdand fourth legs, and the spring further includes a wedge configured tobe received within the cavity to impart bias of second ends toward oneanother. In a further detailed embodiment, the spring comprises a firstspring, the occlusion clamp further comprising: (a) a second springmounted to the first spring, the second spring comprising at least twoelongated legs coupled together at a first end and independentlyrepositionable with respect to one another at second, free ends so thatthe second spring is open-ended, the second spring having a dominantdimension measured from its first end to one of its second ends; and,(b) a third spring mounted to the first spring, the third springcomprising at least two elongated legs coupled together at a first endand independently repositionable with respect to one another at second,free ends so that the third spring is open-ended, the third springhaving a dominant dimension measured from its first end to one of itssecond ends. In still a further detailed embodiment, the first leg iscoupled to the first runner at a first location, the second leg iscoupled to the second runner at a second location, and the firstlocation is approximately the same as the second location along thedominant dimension. In a more detailed embodiment, a first pin ismounted to the first runner, a second pin is mounted to the secondrunner, the first leg traps the first pin to mount the first leg to thefirst runner, and the second leg traps the second pin to mount thesecond leg to the second runner. In a more detailed embodiment, thefirst leg includes a first orifice configured to receive the first pinso that the first leg interposes the first pin and the first runner tomount the first leg to the first runner, and the second leg includes asecond orifice configured to receive the second pin so that the secondleg interposes the second pin and the second runner to mount the secondleg to the second runner. In another more detailed embodiment, the firstorifice is at least partially received within a trench of the firstrunner, and the second orifice is at least partially received within atrench of the second runner. In yet another more detailed embodiment,the first spring comprises a U-shaped primary spring, the second springcomprises a first U-shaped secondary spring, and the third springcomprises a second U-shaped secondary spring. In still another moredetailed embodiment, the first and second U-shaped secondary springs aremounted to opposite lateral sides of the U-shaped primary spring, andthe second ends of each of the second and third U-shaped secondarysprings include enlarged arcuate ends.

In yet another more detailed embodiment of the second aspect, a first ofthe second ends of the first spring, a first of the second ends of thesecond spring, and a first of the second ends of the third spring is atleast partially received within a trench of the first runner, and asecond of the second ends of the first spring, a second of the secondends of the second spring, and a second of the second ends of the thirdspring is at least partially received within a trench of the secondrunner. In yet another more detailed embodiment, the elongated occlusionbeam of the first runner is linear and includes a linear occlusionsurface, and the elongated occlusion beam of the second runner is linearand includes a linear occlusion surface. In a further detailedembodiment, the elongated occlusion beam of the first runner is linearand includes an arcuate occlusion surface, and the elongated occlusionbeam of the second runner is linear and includes an arcuate occlusionsurface. In still a further detailed embodiment, the elongated occlusionbeam of the first runner is arcuate and includes an arcuate occlusionsurface, and the elongated occlusion beam of the second runner isarcuate and includes an arcuate occlusion surface. In a more detailedembodiment, the elongated occlusion beam of the first runner is arcuateand includes a linear occlusion surface, and the elongated occlusionbeam of the second runner is arcuate and includes a linear occlusionsurface. In a more detailed embodiment, the spring is fabricated from atleast one of a metal and a metal alloy, and at least one of the firstrunner and the second runner is fabricate from a polymer. In anothermore detailed embodiment, the clamp further includes a fabricinterposing the first and second runners. In yet another more detailedembodiment, the clamp further includes a C-shaped fabric sleeveencapsulating the occlusion clamp.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevated perspective view of a first exemplary occlusionclip in accordance with the present disclosure.

FIG. 2 is a left profile view of the first exemplary occlusion clip ofFIG. 1 .

FIG. 3 is a frontal view of the first exemplary occlusion clip of FIG. 1.

FIG. 4 is an elevated perspective view of the spring and the dowels ofthe first exemplary occlusion clip of FIG. 1 .

FIG. 5 is an elevated perspective view from the top of a first runner ofthe first exemplary occlusion clip of FIG. 1 .

FIG. 6 is an elevated perspective view from the top of a second runnerof the first exemplary occlusion clip of FIG. 1 .

FIG. 7 is an elevated perspective view of a second exemplary occlusionclip in accordance with the present disclosure.

FIG. 8 is a right profile view of the second exemplary occlusion clip ofFIG. 7 .

FIG. 9 is a frontal view of the second exemplary occlusion clip of FIG.7 .

FIG. 10 is an elevated perspective view of the spring and the dowels ofthe second exemplary occlusion clip of FIG. 7 .

FIG. 11 is an elevated perspective view from the top of a first runnerof the second exemplary occlusion clip of FIG. 7 .

FIG. 12 is an elevated perspective view from the top of a second runnerof the second exemplary occlusion clip of FIG. 7 .

FIG. 13 is an elevated perspective view of a third exemplary occlusionclip in accordance with the present disclosure.

FIG. 14 is a right profile view of the third exemplary occlusion clip ofFIG. 13 .

FIG. 15 is a frontal view of the third exemplary occlusion clip of FIG.13 .

FIG. 16 is an elevated perspective view of the spring and the dowels ofthe third exemplary occlusion clip of FIG. 13 .

FIG. 17 is an elevated perspective view from the top of a first runnerof the third exemplary occlusion clip of FIG. 13 .

FIG. 18 is an elevated perspective view from the top of a second runnerof the third exemplary occlusion clip of FIG. 13 .

FIG. 19 is an elevated perspective view of a fourth exemplary occlusionclip in accordance with the present disclosure.

FIG. 20 is a right profile view of the fourth exemplary occlusion clipof FIG. 19 .

FIG. 21 is a frontal view of the fourth exemplary occlusion clip of FIG.19 .

FIG. 22 is an elevated perspective view of the spring of the fourthexemplary occlusion clip of FIG. 19 .

FIG. 23 is an elevated perspective view from the top of a first runnerand dowel of the fourth exemplary occlusion clip of FIG. 19 .

FIG. 24 is an elevated perspective view from the top of a second runnerof the fourth exemplary occlusion clip of FIG. 19 .

FIG. 25 is an elevated perspective view of a fifth exemplary occlusionclip in accordance with the present disclosure.

FIG. 26 is a right profile view of the fifth exemplary occlusion clip ofFIG. 25 .

FIG. 27 is a frontal view of the fifth exemplary occlusion clip of FIG.25 .

FIG. 28 is an elevated perspective view of the spring of the fifthexemplary occlusion clip of FIG. 25 .

FIG. 29 is an elevated perspective view from the top of an exemplaryrunner and dowel of the fifth exemplary occlusion clip of FIG. 25 .

FIG. 30 is an elevated perspective view from the bottom of an exemplaryrunner of the fifth exemplary occlusion clip of FIG. 25 .

FIG. 31 is a right profile view of the wedge of the fifth exemplaryembodiment of FIG. 25 .

FIG. 32 is an elevated perspective view of a sixth exemplary occlusionclip in accordance with the present disclosure.

FIG. 33 is a right profile view of the sixth exemplary occlusion clip ofFIG. 32 .

FIG. 34 is a frontal view of the sixth exemplary occlusion clip of FIG.32 .

FIG. 35 is an elevated perspective view of the spring of the sixthexemplary occlusion clip of FIG. 32 .

FIG. 36 is an elevated perspective view from the top of an exemplaryrunner of the sixth exemplary occlusion clip of FIG. 32 .

FIG. 37 is a longitudinal cross-sectional view of the exemplary runnerof FIG. 36 .

DETAILED DESCRIPTION

The exemplary embodiments of the present disclosure are described andillustrated below to encompass devices, methods, and techniques forfabricating and using an occlusion clip. Of course, it will be apparentto those of ordinary skill in the art that the embodiments discussedbelow are exemplary in nature and may be reconfigured without departingfrom the scope and spirit of the present disclosure. However, forclarity and precision, the exemplary embodiments as discussed below mayinclude optional steps, methods, and features that one of ordinary skillshould recognize as not being a requisite to fall within the scope ofthe present disclosure.

Referencing FIGS. 1-6 , a first exemplary occlusion clip 100 comprises aspring 102 mounted to a first runner 104 and a second runner 106 using aseries of dowels 108. The spring 102 includes a U-shaped end 110 fromwhich extends a first arm 114 and a second arm 116. The first arm 114 ismounted to the first runner 104 using a single dowel 108, whereas thesecond arm 116 is mounted to the second runner 106 using a pair ofdowels 108. In this exemplary embodiment, the first arm 114 may berectangular or circular in cross-section and a pair of linear segments122, 124 that are interposed by a retention segment 126 that is V-shapedin exemplary form. The first linear segment 122 extends from theU-shaped end 110 and is many multiples in longitudinal length of thesecond linear segment 124. In exemplary form, the end of the first arm114 is denoted by the blunt end of the second linear segment 124.Similarly, the second arm 116 also includes a rectangular cross-sectionand includes first, second, and third linear segments 130, 132, 134. Inthis exemplary embodiment, the second linear segment 132 is longer thaneither the first or third linear segments 130, 134. The totallongitudinal length of the second arm 116 is greater than that of thefirst arm 114, with the longitudinal end of the second arm 116 denotedby the blunt rectangular end of the third linear segment 134.Interposing the linear segments 130, 132, 134 are two retention segments136, 138 embodying an exemplary V-shaped configuration.

In this exemplary embodiment, the first retention segment 126longitudinally interposes the second and third retention segments 136,138 while maintaining a vertically spaced apart orientation. Morespecifically, the first retention segment 126 is vertically oriented inthe opposite direction than are the second and third retention segments136, 138. This results in the apex of the V-shaped profile of the firstretention segments 126 facing vertically toward the apexes of theV-shaped profiles of the second and third retention segments 136, 138.The depth of the V-shaped profile and the separation of the arms 114,116 and linear segment 130 can serve to increase or decrease the springforce bias at the closed position of the occluding clip. Each of theretention segments 126, 136, 138 provides a contact area with arespective runner 104, 106.

The first and second runners 104, 106 have essentially the same shape.Specifically, both runners 104, 106 include a pair of parallelside-walls 150, a longitudinal wall 152, and an end wall 154 that isconcurrently mounted to the foregoing walls. The longitudinal wall 152interposes and joins the parallel walls 150. In exemplary form, theinterior surfaces 158 of the parallel walls 150 are planar and parallelto one another. These planar surfaces 158 cooperate with a planarinterior surface 160 of the longitudinal wall 152 to delineate a blockU-shaped longitudinal cavity 161 where the planar surfaces of theparallel walls are perpendicular to the planar surface of thelongitudinal wall. In addition, the end wall 154 interposes and joinsthe parallel walls 150 to provide a longitudinal end cap. An interiorsurface 162 of the end wall is arcuately shaped and cooperates with theplanar surfaces 158 of the parallel walls 150 to delineate a roundedU-shaped vertical cavity. In sum, the longitudinal end 166 of therunners 104, 106 opposite the end wall 154 is open, as is the verticalend opposite the planar interior surface 160 of the longitudinal wall152.

The exterior of each runner 104, 106 includes a blunt end 170 that isrounded over at its periphery to join opposing longitudinal planarsurfaces 172 and an arcuate longitudinal surface 174. The longitudinalarcuate surfaces 174 are adapted to be the element of each runner 104,106 that is closest to one another and interposed by tissue when in atissue occluding position.

As introduced previously, the first runner 104 is mounted to the spring102 using a dowel 108, whereas the second runner 106 is mounted to thespring using a pair of dowels. Consequently, the first runner 104includes a pair of openings 176 that extend through the parallel walls150 and are coaxial with one another. In this exemplary embodiment, theopenings 176 are cylindrical and arranged approximately in thelongitudinal middle of the first runner 104. In contrast, the secondrunner 106 includes two pair of openings 178, 180 that extend throughthe parallel walls 150 and are coaxial with one another. In thisexemplary embodiment, the openings 178, 180 are cylindrical and thefirst pair of openings 178 occurs at approximately one-third thelongitudinal length, whereas the second pair of openings 180 occurs atapproximately two-thirds the longitudinal length of the second runner106.

Assembly of the first exemplary occlusion clip 100 includeslongitudinally sliding the runners 104, 106 with respect to the spring102 when no dowels 108 are present. By way of example, the first runner104 is oriented in parallel with the first arm 114 so that the open endof the first runner 104 is longitudinally aligned to receive theretention segment 126. Thereafter, the first runner 104 is repositionedwith respect to the first arm 114 so that the retention segment 126 islongitudinally repositioned within the U-shaped cavity 161 until theretention segment 126 is aligned with the pair of openings 176.Thereafter, the dowel 108 is inserted through the pair of openings 176so that the dowel and the planar interior surface 160 of thelongitudinal wall 152 sandwich the retention segment 126. After thedowel 108 is in position, the first runner 104 may not belongitudinally, vertically, or rotationally repositioned with respect tothe first arm 114. Mounting of the second runner 106 to the second arm116 follows a similar process.

Mounting the second runner 106 to the second arm 116 may includelongitudinally sliding the second runner 106 with respect to the spring102 when no dowels 108 extend through the second runner. For example,the second runner 106 is oriented in parallel with the second arm 116 sothat the open end 166 of the first runner 106 is longitudinally alignedto receive the retention segments 136, 138. Thereafter, the secondrunner 106 is repositioned with respect to the second arm 116 so thatthe retention segments 136, 138 are longitudinally repositioned withinthe U-shaped cavity 161 until the retention segments 136, 138 arealigned with respective pairs of openings 178, 180. Thereafter, twodowels 108 are inserted through the two pair of openings 178, 180 sothat the dowels and the planar interior surface 160 of the longitudinalwall 152 sandwich the retention segments 136, 138. After the dowels 108are in position, the second runner 106 may not be longitudinally,vertically, or rotationally repositioned with respect to the second arm116.

In operation, the spring 102 operates to bias the runners 104, 106toward one another to exert an occlusion pressure upon tissue capturedtherebetween. To achieve this bias, the spring 102 may be cast, cut, orfabricated in the shape shown in FIG. 4 . Thereafter, repositioning thefirst arm 114 away from the second arm 116 requires overcoming the biasof the spring 102, including the bias attributed to the U-shaped end 110and the bias attributed to the arms 114, 116 and the linear segment 130.When no active force is exerted upon the arms 114, 116, the arms willdefault to the position shown in FIG. 2 . Consequently, when positioningthe clip 100 to occlude bodily tissue, such as a left atrial appendage,the clip 100 is forced open so that the ends of the arms 114, 116 areforced farther away from one another to create a vertical gap betweenthe runners 104, 106. This vertical gap is wide enough to allow bodilytissue to interpose the runners 104, 106 and, when the active force isno longer exerted upon the arms 114, 116, the bias of the spring 102 isoperative to force the runners toward one another and discontinuecirculation across the tissue interposing the runners. Eventually, theabsence of circulation to one side of the clamped tissue leads toatrophy and occlusion of the bodily tissue in question.

Occlusion of the bodily tissue is accomplished through transferal of theforces imparted by the spring 102 through the runners 104, 106 andtransmitted to the tissue as a pressure profile. The presence ofproximal and distal spring bias allows the occlusion clip runners 104,106 to balance the force independently at the proximal and distal ends,allowing for non-uniform shapes of tissue to be evenly compressedbetween the runners. The desired pressure can be obtained throughadjustment of both the spring force and the runner 104, 106 shape andsize. The spring force is a function of the shape, thickness, and widthof the spring 102 material and each can be independently adjusted toobtain the desired force at the desired separation. Additionally, it isdesired that as the tissue atrophies, a significant force continues tobe applied even as the runners 104, 106 compress the tissue between themto near zero or zero thickness. This “zero offset force” can be adjustedthrough design of the shape of the spring 102 causing the “free state”of the contact points of the spring to the runners 104, 106 to becomecloser together or to even offset in the negative direction. It will beunderstood by those with ordinary skill in the art that this offset maybe designed into the spring 102 or may be introduced through intentionalplastic deformation of the spring.

Referencing FIGS. 7-12 , a second exemplary occlusion clip 200 comprisesa spring 202 mounted to a first runner 204 and a second runner 206 usinga pair of dowels 208. The spring 202 includes a U-shaped end 210 fromwhich extends a first arm 214 and a second arm 216. The first arm 214 ismounted to the first runner 204 using a first dowel 208, whereas thesecond arm 216 is mounted to the second runner 206 using a second dowel208. In this exemplary embodiment, the first arm 214 has a rectangular,linear cross-section except for a distal end 218. The distal end 218 isrounded over and includes spaced apart projections 220, 222 thatdelineate a channel 224 configured to receive a dowel 208. In thisexemplary embodiment, the channel 224 faces away from the second arm216.

Similarly, the second arm 216 also has a rectangular, linear or circularcross-section except for a distal end 228 and a rounded hump 230extending toward the first arm 214. In this exemplary embodiment, thesecond arm 216 includes a first linear segment 232 and a second linearsegment 234 that are interposed by the hump 230. Though not required,the longitudinal length of the second linear segment 234 is greater thanthat of the first linear segment 232.

In this exemplary embodiment, the distal end 228 is rounded over andincludes spaced apart projections 240, 242 that delineate a channel 244configured to receive a dowel 208. In exemplary form, the channel 244faces away from the first arm 214. It should also be noted that therounded vertical height of the distal end 228 is approximately equal tothe vertical height of the rounded hump 230. Both the rounded hump 230and rounded distal end 228 of the second arm 216 provide respectivecontact areas for the second runner 206.

The first and second runners 204, 206 have essentially the same shape.Specifically, both runners 204, 206 include a pair of parallel walls250, a longitudinal wall 252, and an end wall 254 that is concurrentlymounted to the foregoing walls. The longitudinal wall 252 interposes andjoins the parallel walls 250. In exemplary form, the interior surfaces258 of the parallel walls 250 are planar and parallel to one another.These planar surfaces 258 cooperate with a planar interior surface 260of the longitudinal wall 252 to delineate a block U-shaped longitudinalcavity 261 where the planar surfaces of the parallel walls areperpendicular to the planar surface of the longitudinal wall. Inaddition, the end wall 254 interposes and joins the parallel walls 250to provide a longitudinal end cap. An interior surface 262 of the endwall is arcuately shaped and cooperates with the planar surfaces 258 ofthe parallel walls 250 to delineate a rounded U-shaped vertical cavity.In sum, the longitudinal end 266 of the runners 204, 206 opposite theend wall 254 is open, as is the vertical end opposite the planarinterior surface 260 of the longitudinal wall 252.

The exterior of each runner 204, 206 includes a blunt end 270 that isrounded over at its periphery to join opposing longitudinal planarsurfaces 272 and an arcuate longitudinal surface 274. The longitudinalarcuate surfaces 274 are adapted to be the element of each runner 204,206 that is closest to one another and interposed by tissue when in atissue occluding position.

As introduced previously, the first and second runners 204, 206 aremounted to the spring 202 using respective dowels 208. Consequently, thefirst runner 204 includes a pair of openings 276 that extend through theparallel walls 250 and are coaxial with one another. In this exemplaryembodiment, the openings 276 are cylindrical and arranged distally justbeyond the longitudinal middle of the first runner 204. Likewise, thesecond runner 206 includes a pair of openings 278 that extend throughthe parallel walls 250 and are coaxial with one another. In thisexemplary embodiment, the openings 278 are cylindrical and the firstpair of openings 278 are arranged approximately at eighty percent of thelongitudinal length (i.e., nearest the distal end).

Assembly of the second exemplary occlusion clip 200 includeslongitudinally sliding the runners 204, 206 with respect to the spring202 when no dowels 208 are present. By way of example, the first runner204 is oriented to be slightly angled with respect to the first arm 214so that the open end of the first runner 204 is longitudinally alignedto receive the rounded distal end 218. Thereafter, the first runner 204is repositioned with respect to the first arm 214 so that the distal end218 is longitudinally repositioned within the U-shaped cavity 261 untilthe distal end 218 is aligned with the pair of openings 276. Thereafter,the dowel 208 is inserted through the pair of openings 276 so that thedowel and the planar interior surface 260 of the longitudinal wall 252sandwich the distal end 218. After the dowel 208 is in position, thefirst runner 204 may not be longitudinally or vertically repositionedwith respect to the first arm 214. But the first runner 204 may berotationally repositionable with respect to the first arm 214 about anaxis coaxial with the longitudinal length of the dowel 208. Mounting ofthe second runner 206 to the second arm 216 follows a similar process.

Mounting the second runner 206 to the second arm 216 may includelongitudinally sliding the runner 206 with respect to the spring 202when no dowel 208 extends through the second runner. For example, thesecond runner 206 is oriented in parallel with the second arm 216 sothat the open end 266 of the first runner 206 is longitudinally alignedto receive the rounded distal end 228. Thereafter, the second runner 206is repositioned with respect to the second arm 216 so that the roundeddistal end 228 is longitudinally repositioned within the U-shaped cavity261 until the distal end is aligned with the pair of openings 278.Thereafter, the dowel 208 is inserted through the pair of opening 278 sothat the dowel and the planar interior surface 260 of the longitudinalwall 252 sandwich the distal end 228. After the dowel 208 is inposition, the second runner 206 may not be longitudinally or verticallyrepositioned with respect to the second arm 216, but may be rotationallyrepositionable with respect to the second arm 216 about an axis coaxialwith the longitudinal length of the dowel 208.

In operation, the spring 202 operates to bias the runners 204, 206toward one another to exert an occlusion pressure upon tissue capturedtherebetween. To achieve this bias, the spring 202 may be cast, cut, orfabricated in the shape shown in FIG. 10 . Thereafter, repositioning thefirst arm 214 away from the second arm 216 requires overcoming the biasof the spring, principally the bias attributed to the U-shaped end 210.When no active force is exerted upon the arms 214, 216, the arms willdefault to the position shown in FIG. 8 . Consequently, when positioningthe clip 200 to occlude bodily tissue, such as a left atrial appendage,the clip 200 is forced open so that the ends of the arms 214, 216 areforced farther away from one another to create a vertical gap betweenthe runners 204, 206. This vertical gap is wide enough to allow bodilytissue to interpose the runners 204, 206 and, when the active force isno longer exerted upon the arms 214, 216, the bias of the spring 202 isoperative to force the runners toward one another and discontinuecirculation across the tissue interposing the runners. Eventually, theabsence of circulation to one side of the clamped tissue leads toatrophy and occlusion of the bodily tissue in question.

As discussed previously, occlusion of the bodily tissue is accomplishedthrough transferal of the forces imparted by the spring 202 through therunners 204, 206 and transmitted to the tissue as a pressure profile.The presence of proximal and distal spring bias allows the runners 204,206 to balance the force independently at the proximal and distal ends,allowing for non-uniform shapes of tissue to be evenly compressedbetween the runners. The desired pressure can be obtained throughadjustment of both the spring force and the runners 204, 206 shape andsize. The spring force is a function of the shape, thickness, and widthof the spring 202 material and each can be independently adjusted toobtain the desired force at the desired separation. Additionally, it isdesired that as the tissue atrophies, a significant force continues tobe applied even as the runners 204, 206 compress the tissue between themto near zero or zero thickness. This “zero offset force” can be adjustedthrough design of the shape of the spring 202 causing the “free state”of the contact points of the spring to the runners 204, 206 to becomecloser together or to even offset in the negative direction. It will beunderstood by those with ordinary skill in the art that this offset maybe designed into the spring 202 or may be introduced through intentionalplastic deformation of the spring.

Referencing FIGS. 13-18 , a third exemplary occlusion clip 300 comprisesa spring 302 mounted to a first runner 304 and a second runner 306 usinga pair of dowels 308. The spring 302 includes a U-shaped end 310 fromwhich extends a first arm 314 and a second arm 316. The first arm 314 ismounted to the first runner 304 using a first dowel 308, whereas thesecond arm 316 is mounted to the second runner 306 using a second dowel308. In this exemplary embodiment, the first arm 314 has a rectangular,linear cross-section except for a distal end 318. The distal end 318 isrounded over and includes an orifice 324 configured to receive a dowel308. Similarly, the second arm 316 also has a rectangular, linear orcircular cross-section except for a rounded distal end 328. In thisexemplary embodiment, the rounded end 328 includes an orifice 330configured to receive the dowel 308. In this exemplary embodiment, thelongitudinal length of each of the arms 314, 316 is approximately equal.

In addition to the first and second arms 314, 316, a secondary appendage334 is mounted to the U-shaped end 310. In exemplary form, the secondaryappendage 334 is inset with respect to the U-shaped end 310 and includesan arcuate portion 336 that approximates the curvature of the U-shapedportion until transitioning to a linear portion 338 that extendsdistally and divergent with respect to the first arm 314. Specifically,the linear portion 338 is acutely angled with respect to the first arm314.

The first and second runners 304, 306 have essentially the same shape.Specifically, both runners 304, 306 include a pair of parallel walls350, a longitudinal wall 352, and an end wall 354 that is concurrentlymounted to the foregoing walls. The longitudinal wall 352 interposes andjoins the parallel walls 350. In exemplary form, the interior surfaces358 of the parallel walls 350 are planar and parallel to one another.These planar surfaces 358 cooperate with a planar interior surface 360of the longitudinal wall 352 to delineate a block U-shaped longitudinalcavity 361 where the planar surfaces of the parallel walls areperpendicular to the planar surface of the longitudinal wall. Inaddition, the end wall 354 interposes and joins the parallel walls 350to provide a longitudinal end cap. An interior surface 362 of the endwall is arcuately shaped and cooperates with the planar surfaces 358 ofthe parallel walls 350 to delineate a rounded U-shaped vertical cavity.In sum, the longitudinal end 366 of the runners 304, 306 opposite theend wall 354 is open, as is the vertical end opposite the planarinterior surface 360 of the longitudinal wall 352.

The exterior of each runner 304, 306 includes a blunt end 370 that isrounded over at its periphery to join opposing longitudinal planarsurfaces 372 and an arcuate longitudinal surface 374. The longitudinalarcuate surfaces 374 are adapted to be the element of each runner 304,306 that is closest to one another and interposed by tissue when in atissue occluding position.

As introduced previously, the first and second runners 304, 306 aremounted to the spring 302 using respective dowels 308. Consequently, thefirst runner 304 includes a pair of openings 376 that extend through theparallel walls 350 and are coaxial with one another. In this exemplaryembodiment, the openings 376 are cylindrical and arranged approximatelyat eighty percent of the longitudinal length (i.e., nearest the distalend) of the first runner 304. Likewise, the second runner 306 includes apair of openings 378 that extend through the parallel walls 350 and arecoaxial with one another. In this exemplary embodiment, the openings 378are cylindrical and the first pair of openings 378 are arrangedapproximately at eighty percent of the longitudinal length (i.e.,nearest the distal end).

Assembly of the third exemplary occlusion clip 300 includeslongitudinally sliding the runners 304, 306 with respect to the spring302 when no dowels 308 are present. By way of example, the first runner304 is oriented to be slightly angled with respect to the first arm 314so that the open end of the first runner 304 is longitudinally alignedto receive the rounded distal end 318. Thereafter, the first runner 304is repositioned with respect to the first arm 314 so that the distal end318 and the secondary appendage 334 are longitudinally repositionedwithin the U-shaped cavity 361 until the distal end 318 is aligned withthe pair of openings 376. Thereafter, the dowel 308 is inserted throughthe pair of openings 376 so that the dowel and the planar interiorsurface 360 of the longitudinal wall 352 sandwich the distal end 318.After the dowel 308 is in position, the first runner 304 may not belongitudinally or vertically repositioned with respect to the first arm314. But the first runner 304 may be rotationally repositionable withrespect to the first arm 314 about an axis coaxial with the longitudinallength of the dowel 308 where the bias of the secondary appendage 334retards rotation of the proximal end of the runner 304 to approximate aparallel orientation with respect to the secondary appendage. Mountingof the second runner 306 to the second arm 316 follows a similarprocess.

Mounting the second runner 306 to the second arm 316 may includelongitudinally sliding the second runner 306 with respect to the spring302 when no dowel 308 extends through the second runner. For example,the second runner 306 is oriented in parallel with the second arm 316 sothat the open end 366 of the first runner 306 is longitudinally alignedto receive the rounded distal end 328. Thereafter, the second runner 306is repositioned with respect to the second arm 316 so that the roundeddistal end 328 is longitudinally repositioned within the U-shaped cavity361 until the rounded distal end is aligned with the pair of openings378. Thereafter, the dowel 308 is inserted through the pair of opening378 so that the dowel and the planar interior surface 360 of thelongitudinal wall 352 sandwich the distal end 328. After the dowel 308is in position, the second runner 306 may not be longitudinally orvertically repositioned with respect to the second arm 316, but may berotationally repositionable with respect to the second arm 316 about anaxis coaxial with the longitudinal length of the dowel 308.

In operation, the spring 302 operates to bias the runners 304, 306toward one another to exert an occlusion pressure upon tissue capturedtherebetween. To achieve this bias, the spring 302 may be cast, cut, orfabricated in the shape shown in FIG. 16 . Thereafter, repositioning thefirst arm 314 away from the second arm 316 requires overcoming the biasof the spring 302, principally the bias attributed to the U-shaped end310 and the secondary appendage 334. When no active force is exertedupon the arms 314, 316 and the secondary appendage 334, the arms andsecondary appendage will default to the position shown in FIG. 14 .Consequently, when positioning the clip 300 to occlude bodily tissue,such as a left atrial appendage, the clip 300 is forced open so that thedistal ends of the arms 314, 316 are forced farther away from oneanother to create a vertical gap between the runners 304, 306. Thisvertical gap is wide enough to allow bodily tissue to interpose therunners 304, 306 and, when the active force is no longer exerted uponthe arms 314, 316 and secondary appendage 334, the bias of the spring302 is operative to force the runners toward one another and discontinuecirculation across the tissue interposing the runners. Eventually, theabsence of circulation to one side of the clamped tissue leads toatrophy and occlusion of the bodily tissue in question.

As introduced previously, occlusion of the bodily tissue is accomplishedthrough transferal of the forces imparted by the spring 302 through therunners 304, 306 and transmitted to the tissue as a pressure profile.The presence of proximal and distal spring bias allows the occlusionclip runners 304, 306 to balance the force independently at the proximaland distal ends, allowing for non-uniform shapes of tissue to be evenlycompressed between the runners. The desired pressure can be obtainedthrough adjustment of both the spring force and the runner 304, 306shape and size. The spring force is a function of the shape, thickness,and width of the spring 302 material and each can be independentlyadjusted to obtain the desired force at the desired separation.Additionally, it is desired that as the tissue atrophies, a significantforce continues to be applied even as the runners 304, 306 compress thetissue between them to near zero or zero thickness. This “zero offsetforce” can be adjusted through design of the shape of the spring 302causing the “free state” of the contact points of the spring to therunners 304, 306 to become closer together or to even offset in thenegative direction. It will be understood by those with ordinary skillin the art that this offset may be designed into the spring 302 or maybe introduced through intentional plastic deformation of the spring.

Referencing FIGS. 19-24 , a fourth exemplary occlusion clip 400comprises a spring 402 mounted to a first runner 404 and a second runner406 using a pair of dowels 408. The spring 402 includes a U-shaped end410 from which extends a first arm 414 and a second arm 416. The firstarm 414 is mounted to the first runner 404 using the first dowel 408,whereas the second arm 416 is mounted to the second runner 406 using thesecond dowel 408. In this exemplary embodiment, the first arm 414 has arectangular or circular cross-section except for a distal end 418. Thefirst arm 414 includes a first linear segment 420 that is obtuselyangled with respect to a second linear segment 422 that terminates atthe distal end 418. The distal end 418 is rounded over and includes anorifice 424 configured to receive the dowel 408. Similarly, the secondarm 416 also has a rectangular or circular, linear cross-section exceptfor a rounded distal end 428. The second arm 416 includes a first linearsegment 430 that is obtusely angled with respect to a second linearsegment 432 that terminates at the distal end 428. In this exemplaryembodiment, the rounded end 428 includes an orifice 434 configured toreceive the dowel 408. In this exemplary embodiment, the longitudinallength of each of the arms 414, 416 is approximately equal.

In addition to the first and second arms 414, 416, a pair of secondaryappendages 444, 446 is mounted to the U-shaped end 410. In exemplaryform, the secondary appendages 444, 446 are inset with respect to theU-shaped end 410 and each appendage includes an arcuate portion 448, 449that approximates the curvature of the U-shaped portion untiltransitioning to a linear portion 438, 440. The first linear portion 438extends distally and divergent with respect to the first arm 414,whereas the second linear portion 440 extends distally and divergentwith respect to the second arm 416. Specifically, the first linearportion 438 is acutely angled with respect to the first arm 414, whilethe second linear portion 440 is acutely angled with respect to thesecond arm 416.

The first and second runners 404, 406 have essentially the same shape.Specifically, both runners 404, 406 include a pair of parallel walls450, a longitudinal wall 452, and an end wall 454 that is concurrentlymounted to the foregoing walls. The longitudinal wall 452 interposes andjoins the parallel walls 450. In exemplary form, the interior surfaces458 of the parallel walls 450 are planar and parallel to one another.These planar surfaces 458 cooperate with a planar interior surface 460of the longitudinal wall 452 to delineate a block U-shaped longitudinalcavity 461 where the planar surfaces of the parallel walls 450 areperpendicular to the planar surface of the longitudinal wall. Inaddition, the end wall 454 interposes and joins the parallel walls 450to provide a longitudinal end cap. An interior surface 462 of the endwall is arcuately shaped and cooperates with the planar surfaces 458 ofthe parallel walls 450 to delineate a rounded U-shaped vertical cavity.In sum, the longitudinal end 466 of the runners 404, 406 opposite theend wall 454 is open, as is the vertical end opposite the planarinterior surface 460 of the longitudinal wall 452.

The exterior of each runner 404, 406 includes a blunt end 470 that isrounded over at its periphery to join opposing longitudinal planarsurfaces 472 and an arcuate longitudinal surface 474. The longitudinalarcuate surfaces 474 are adapted to be the element of each runner 404,406 that is closest to one another and interposed by tissue when in atissue occluding position.

As introduced previously, the first and second runners 404, 406 aremounted to the spring 402 using respective dowels 408. Consequently, thefirst and second runners 404, 406 each include a pair of openings 476that extend through the parallel walls 450 and are coaxial with oneanother. In this exemplary embodiment, the openings 476 are cylindricaland arranged approximately at eighty percent of the longitudinal length(i.e., nearest the distal end) of the runners 404, 406.

Assembly of the fourth exemplary occlusion clip 400 includeslongitudinally sliding the runners 404, 406 with respect to the spring402 when no dowels 408 are present. By way of example, the first runner404 is oriented to be slightly angled with respect to the first arm 414so that the open end of the first runner 404 is longitudinally alignedto receive the rounded distal end 418. Thereafter, the first runner 404is repositioned with respect to the first arm 414 so that the distal end418 and a first of the secondary appendages 438 are longitudinallyrepositioned within the U-shaped cavity 461 until the distal end 418 isaligned with the pair of openings 476. Thereafter, the dowel 408 isinserted through the pair of openings 476 so that the dowel and theplanar interior surface 460 of the longitudinal wall 452 sandwich thedistal end 418. After the dowel 408 is in position, the first runner 404may not be longitudinally or vertically repositioned with respect to thefirst arm 414. But the first runner 404 may be rotationallyrepositionable with respect to the first arm 414 about an axis coaxialwith the longitudinal length of the dowel 408 where the bias of a firstof the secondary appendages 438 retards rotation of the proximal end ofthe runner 404 to approximate a parallel orientation with respect to thesecondary appendage. Mounting of the second runner 406 to the second arm416 follows a similar process.

Mounting the second runner 406 to the second arm 416 may includelongitudinally sliding the runner 406 with respect to the spring 402when no dowel 408 extends through the second runner. For example, thesecond runner 406 is oriented to be slightly angled with respect to thesecond arm 416 so that the open end of the second runner 406 islongitudinally aligned to receive the rounded distal end 428.Thereafter, the second runner 406 is repositioned with respect to thesecond arm 416 so that the distal end 428 and a second of the secondaryappendages 440 are longitudinally repositioned within the U-shapedcavity 461 until the distal end 428 is aligned with the pair of openings476. Thereafter, the dowel 408 is inserted through the pair of openings476 so that the dowel and the planar interior surface 460 of thelongitudinal wall 452 sandwich the distal end 428. After the dowel 408is in position, the second runner 406 may not be longitudinally orvertically repositioned with respect to the second arm 416. But thesecond runner 406 may be rotationally repositionable with respect to thesecond arm 416 about an axis coaxial with the longitudinal length of thedowel 408 where the bias of a second of the secondary appendages 440retards rotation of the proximal end of the runner 406 to approximate aparallel orientation with respect to the secondary appendage.

In operation, the spring 402 operates to bias the runners 404, 406toward one another to exert an occlusion pressure upon tissue capturedtherebetween. To achieve this bias, the spring 402 may be cast, cut, orfabricated in the shape shown in FIG. 22 . Thereafter, repositioning thefirst arm 414 away from the second arm 416 requires overcoming the biasof the spring, principally the bias attributed to the U-shaped end 410and the secondary appendages 438, 440. When no active force is exertedupon the arms 414, 416 and the secondary appendages 438, 440, the armsand appendages will default to the position shown in FIG. 20 .Consequently, when positioning the clip 400 to occlude bodily tissue,such as a left atrial appendage, the clip 400 is forced open so that thedistal ends of the arms 414, 416 are forced farther away from oneanother to create a vertical gap between the runners 404, 406. Thisvertical gap is wide enough to allow bodily tissue to interpose therunners 404, 406 and, when the active force is no longer exerted uponthe arms 414, 416 and secondary appendages 438, 440, the bias of thespring 402 is operative to force the runners toward one another anddiscontinue circulation across the tissue interposing the runners.Eventually, the absence of circulation to one side of the clamped tissueleads to atrophy and occlusion of the bodily tissue in question.

As mentioned, occlusion of the bodily tissue is accomplished throughtransferal of the forces imparted by the spring 402 through the runners404, 406 and transmitted to the tissue as a pressure profile. Thepresence of proximal and distal spring bias allows the occlusion cliprunners 404, 406 to balance the force independently at the proximal anddistal ends, allowing for non-uniform shapes of tissue to be evenlycompressed between the runners. The desired pressure can be obtainedthrough adjustment of both the spring force and the runner 404, 406shape and size. The spring force is a function of the shape, thickness,and width of the spring 402 material and each can be independentlyadjusted to obtain the desired force at the desired separation.Additionally, it is desired that as the tissue atrophies, a significantforce continues to be applied even as the runners 404, 406 compress thetissue between them to near zero or zero thickness. This “zero offsetforce” can be adjusted through design of the shape of the spring 402causing the “free state” of the contact points of the spring to therunners 404, 406 to become closer together or to even offset in thenegative direction. It will be understood by those with ordinary skillin the art that this offset may be designed into the spring 402 or maybe introduced through intentional plastic deformation of the spring.

Referencing FIGS. 25-31 , a fifth exemplary occlusion clip 500 comprisesa spring 502 mounted to a first runner 504 and a second runner 506 usinga pair of dowels 508. The spring 502 includes a V-shaped end 510 fromwhich extends a first arm 514 and a second arm 516. The first arm 514 ismounted to the first runner 504 using the first dowel 508, whereas thesecond arm 516 is mounted to the second runner 506 using the seconddowel 508. In this exemplary embodiment, the first arm 514 has arectangular cross-section except for a rounded distal end 518. The firstarm 514 is longitudinally arcuate and terminates at the distal end 518.The distal end 518 includes an orifice 524 configured to receive thedowel 508. Similarly, the second arm 516 also has a rectangularcross-section except for a rounded distal end 528. The second arm 516 islongitudinally arcuate and terminates at the distal end 528. In thisexemplary embodiment, the rounded end 528 includes an orifice 534configured to receive the dowel 508. In exemplary form, the longitudinallength of each of the arms 514, 516 is approximately equal.

In addition to the first and second arms 514, 516, a pair of secondaryappendages 544, 546 is mounted to the V-shaped end 510. In exemplaryform, the secondary appendages 544, 546 are inset with respect to theV-shaped end 510 and each appendage is longitudinally arcuate. The firstsecondary appendage 544 extends distally and divergent with respect tothe first arm 514, whereas the second secondary appendage 546 extendsdistally and divergent with respect to the second arm 516.

The first and second runners 504, 506 have essentially the same shape.Specifically, both runners 504, 506 include a pair of parallel walls550, a longitudinal wall 552, and an end wall 554 that is concurrentlymounted to the foregoing walls. The longitudinal wall 552 interposes andjoins the parallel walls 550. In exemplary form, the interior surfaces558 of the parallel walls 550 are planar and parallel to one another.These planar surfaces 558 cooperate with a planar interior surface 560of the longitudinal wall 552 to delineate a block U-shaped longitudinalcavity 561 where the planar surfaces of the parallel walls areperpendicular to the planar surface of the longitudinal wall. Inaddition, the end wall 554 interposes and joins the parallel walls 550to provide a longitudinal end cap. An interior surface 562 of the endwall is arcuately shaped and cooperates with the planar surfaces 558 ofthe parallel walls 550 to delineate a rounded U-shaped vertical cavity.In sum, the longitudinal end 566 of the runners 504, 506 opposite theend wall 554 is open, as is the vertical end opposite the planarinterior surface 560 of the longitudinal wall 552.

The exterior of each runner 504, 506 includes a blunt end 570 that isrounded over at its periphery to join opposing longitudinal planarsurfaces 572 and an arcuate longitudinal surface 574. The longitudinalarcuate surfaces 574 are adapted to be the element of each runner 504,506 that is closest to one another and interposed by tissue when in atissue occluding position.

As introduced previously, the first and second runners 504, 506 aremounted to the spring 502 using respective dowels 508. Consequently, thefirst and second runners 504, 506 each include a pair of openings 576that extend through the parallel walls 550 and are coaxial with oneanother. In this exemplary embodiment, the openings 576 are cylindricaland arranged approximately at eighty percent of the longitudinal length(i.e., nearest the distal end) of the runners 504, 506.

In this exemplary embodiment, a wedge 580 is coupled to the spring 502to change the bias exerted by the first and second arms 514, 516. Inthis exemplary embodiment, the wedge 580 is welded to the spring 502.Exemplary forms of welding include, without limitation, sonic welding,friction welding (including friction stir welding), electromagneticpulse welding, co-extrusion welding, cold welding, diffusion bonding,exothermic welding, high frequency welding, hot pressure welding, andinduction welding. Nevertheless, other forms of attachment may beutilized to mount the wedge 580 to the spring 502 using various forms ofattachment including, without limitation, adhesive, friction fit, andsnap-fit (including detents, etc.).

Those skilled in the art will be aware that changing the shape of thewedge 580 with respect to the spring 502 is operative to change the biasexerted by the first and second arms 514, 516. Accordingly, the shapeand angle of the wedge 580 and the cavity within the spring 502 intowhich the wedge is received is a matter of design choice. For example,as the pie-shape of the wedge increases in angle, the bias exerted uponthe first and second arms 514, 516 will generally increase. Conversely,as the pie-shape of the wedge 580 decreases in angle, the bias exertedupon the first and second arms 514, 516 will generally decrease. Itshould be understood that shapes other than a pie-shape may be used todefine the contour of the wedge 580. Those skilled in the art in view ofthe disclosure herein will readily understand these design alternatives.

Assembly of the fifth exemplary occlusion clip 500 includeslongitudinally sliding the runners 504, 506 with respect to the spring502 when no dowels 508 are present. By way of example, the first runner504 is oriented to be slightly angled with respect to the first arm 514so that the open end of the first runner 504 is longitudinally alignedto receive the rounded distal end 518. Thereafter, the first runner 504is repositioned with respect to the first arm 514 so that the distal end518 and a first of the secondary appendages 544 are longitudinallyrepositioned within the U-shaped cavity 561 until the distal end 518 isaligned with the pair of openings 576. Thereafter, the dowel 508 isinserted through the pair of openings 576 so that the dowel and theplanar interior surface 560 of the longitudinal wall 552 sandwich thedistal end 518. After the dowel 508 is in position, the first runner 504may not be longitudinally or vertically repositioned with respect to thefirst arm 514. But the first runner 504 may be rotationallyrepositionable with respect to the first arm 514 about an axis coaxialwith the longitudinal length of the dowel 508 where the bias of a firstof the secondary appendages 544 retards rotation of the proximal end ofthe runner 504 to approximate a parallel orientation with respect to thesecondary appendage. Mounting of the second runner 506 to the second arm516 follows a similar process.

Mounting the second runner 506 to the second arm 516 may includelongitudinally sliding the runner 506 with respect to the spring 502when no dowel 508 extends through the second runner. For example, thesecond runner 506 is oriented to be slightly angled with respect to thesecond arm 516 so that the open end of the second runner 506 islongitudinally aligned to receive the rounded distal end 528.Thereafter, the second runner 506 is repositioned with respect to thesecond arm 516 so that the distal end 528 and a second of the secondaryappendages 546 are longitudinally repositioned within the U-shapedcavity 561 until the distal end 528 is aligned with the pair of openings576. Thereafter, the dowel 508 is inserted through the pair of openings576 so that the dowel and the planar interior surface 560 of thelongitudinal wall 552 sandwich the distal end 528. After the dowel 508is in position, the second runner 506 may not be longitudinally orvertically repositioned with respect to the second arm 516. But thesecond runner 506 may be rotationally repositionable with respect to thesecond arm 516 about an axis coaxial with the longitudinal length of thedowel 508 where the bias of a second of the secondary appendages 546retards rotation of the proximal end of the runner 506 to approximate aparallel orientation with respect to the secondary appendage.

In operation, the spring 502 and wedge 580 operate to bias the runners504, 506 toward one another to exert an occlusion pressure upon tissuecaptured therebetween To achieve this bias, the spring 502 may be cast,cut, or fabricated in the shape shown in FIG. 28 . Repositioning thefirst arm 514 away from the second arm 516 requires overcoming the biasof the spring 502, principally the bias attributed to the V-shaped end510 and the secondary appendages 544, 546. It should be noted that thebias of the spring 502 changes depending upon the properties of thewedge 580 including, without limitation, size, shape, and materialcomposition. In exemplary form, the bias of the spring 502 is most oftenincreased when the wedge 580 is mounted to the spring. Conversely, whenthe wedge 580 is not mounted to the spring 502, the bias associated withthe spring will most often decrease as the spring 502 flexes about itshinge 590. When no active force is exerted upon the arms 514, 516 andthe secondary appendages 544, 546, the arms and appendages will defaultto the position shown in FIG. 26 . Consequently, when positioning theclip 500 to occlude bodily tissue, such as a left atrial appendage, theclip 500 is forced open so that the distal ends of the arms 514, 516 areforced farther away from one another to create a vertical gap betweenthe runners 504, 506. This vertical gap is wide enough to allow bodilytissue to interpose the runners 504, 506 and, when the active force isno longer exerted upon the arms 514, 516 and secondary appendages 544,546, the bias of the spring 502 is operative to force the runners towardone another and discontinue circulation across the tissue interposingthe runners. Eventually, the absence of circulation to one side of theclamped tissue leads to atrophy and occlusion of the bodily tissue inquestion.

Similar to the foregoing embodiments, occlusion of the bodily tissue isaccomplished through transferal of the forces imparted by the spring 502through the runners 504, 506 and transmitted to the tissue as a pressureprofile. The presence of proximal and distal spring bias allows theocclusion clip runners 504, 506 to balance the force independently atthe proximal and distal ends, allowing for non-uniform shapes of tissueto be evenly compressed between the runners. The desired pressure can beobtained through adjustment of both the spring force and the runner 504,506 shape and size. The spring force is a function of the shape,thickness, and width of the spring 502 material and each can beindependently adjusted to obtain the desired force at the desiredseparation. Additionally, it is desired that as the tissue atrophies, asignificant force continues to be applied even as the runners 504, 506compress the tissue between them to near zero or zero thickness. This“zero offset force” can be adjusted through design of the shape of thespring 502 causing the “free state” of the contact points of the springto the runners 504, 506 to become closer together or to even offset inthe negative direction. It will be understood by those with ordinaryskill in the art that this offset may be designed into the spring 502 ormay be introduced through intentional plastic deformation of the spring.

Referencing FIGS. 32-37 , a sixth exemplary occlusion clip 600 comprisesa spring 602 mounted to a first runner 604 and a second runner 606 usinga pair of dowels 608. The spring 602 includes a U-shaped end 610 fromwhich extends a first arm 614 and a second arm 616. The first arm 614 ismounted to the first runner 604 using the first dowel 608, whereas thesecond arm 616 is mounted to the second runner 606 using the seconddowel 608. In this exemplary embodiment, the first arm 614 has arectangular or circular cross-section except for a rounded distal end618. The first arm 614 is longitudinally linear and terminates at thedistal end 618. The distal end 618 includes an orifice 624 configured toreceive the dowel 608. Similarly, the second arm 616 also has arectangular cross-section except for a rounded distal end 628. Thesecond arm 616 is longitudinally linear and terminates at the distal end628. In this exemplary embodiment, the rounded end 628 includes anorifice 634 configured to receive a dowel 608. In exemplary form, thelongitudinal length of each of the arms 614, 616 is approximately equal.

In addition to the first and second arms 614, 616, a first and secondpair of ancillary appendages 644, 646 are mounted to the U-shaped end610. In exemplary form, the ancillary appendages 644, 646 sandwich arespective arm 614, 616. Each of the ancillary appendages 644, 646comprises a rectangular cross-section except for a rounded distal end647, 649. Each ancillary appendage 644, 646 is longitudinally arcuate tocurve toward the interior interposing the arms 614, 616, where thedistal ends 647, 649 are closest to one another.

The first and second runners 604, 606 have essentially the same shape.Specifically, both runners 604, 606 have a cylindrical, linear exteriorsurface 650 that tapers to create a domed end 652. A proximal end 654defines a U-shaped opening that leads into a longitudinally extendingchannel 656 delineated by interior walls configured to receive arespective arm 614, 616 and a respective pair of ancillary appendages644, 646. In particular, the interior walls define a pair of spacedapart inclined, linear ramps 658 (from proximal to distal) that providea bearing surface upon which a respective distal end 647, 649 slides. Inorder to fix the orientation and mount the ancillary appendages 644, 646to the runner 604, 606, the interior of the runner adjacent the distalend of each ramp 658 defines a pocket 660. Interposing the pockets is aprimary inclined linear ramp 664 (from proximal to distal) that providea bearing surface upon which a respective distal end 618, 628 slides. Inorder to fix the orientation and mount a respective arm 614, 616 to arunner 604, 606, the interior of the runner adjacent the distal end ofeach ramp 658 defines a primary pocket 668. Extending transverse acrossthis primary pocket is a pair of orifices 670 extending through theexterior surface 650. Each orifice 670 is cylindrical and sized toaccept the dowel 608 in order to lock a respective arm 614, 616 to arespective runner 604, 606. In this exemplary embodiment, the orifices670 are cylindrical and arranged approximately at eighty percent of thelongitudinal length (i.e., nearest the distal end) of the runners 604,606.

Assembly of the sixth exemplary occlusion clip 600 includeslongitudinally sliding the runners 604, 606 with respect to the spring602 when no dowels 608 are present. By way of example, the first runner604 is oriented to be slightly angled with respect to the first arm 614so that the open end of the first runner 604 is longitudinally alignedto receive the rounded distal end 618. Thereafter, the first runner 604is repositioned with respect to the first arm 614 so that the distal end618 and the first pair of ancillary appendages 644 are longitudinallyrepositioned within the U-shaped cavity 656. Initially, the roundeddistal end 618 contacts and rides upon the primary ramp 664, followed bycontinued longitudinal movement that causes the distal ends 647 of thefirst ancillary appendages 644 to slide upon a respective linear ramp658. Eventual longitudinal movement of the spring 602 with respect tothe first runner 604 coincides with the rounded distal end 618 reachingthe primary pocket 668 at approximately the same time as the distal ends647 reaching respective pockets 660. Thereafter, the dowel 608 isinserted through the pair of openings 670 and through the orifice 624 ofthe first arm 614 to lock the first arm to the runner. After the dowel608 is in position, the first runner 604 may not be longitudinally orvertically repositioned with respect to the first arm 614. But the firstrunner 604 may be rotationally repositionable with respect to the firstarm 614 about an axis coaxial with the longitudinal length of the dowel608 where the bias of the first pair of ancillary appendages 644 retardsrotation of the proximal end of the runner 604. Mounting of the secondrunner 606 to the second arm 616 follows a similar process.

Mounting the second runner 606 to the second arm 616 may includelongitudinally sliding the runner 606 with respect to the spring 602when no dowel 608 extends through the second runner. For example, thesecond runner 606 is oriented to be slightly angled with respect to thesecond arm 616 so that the open end of the second runner 606 islongitudinally aligned to receive the rounded distal end 628.Thereafter, the second runner 606 is repositioned with respect to thesecond arm 616 so that the distal end 628 and the first pair ofancillary appendages 646 are longitudinally repositioned within theU-shaped cavity 656. Initially, the rounded distal end 628 contacts andrides upon the primary ramp 664, followed by continued longitudinalmovement that causes the distal ends 649 of the second ancillaryappendages 646 to slide upon a respective linear ramp 658. Eventuallongitudinal movement of the spring 602 with respect to the secondrunner 606 coincides with the rounded distal end 628 reaching theprimary pocket 668 at approximately the same time as the distal ends 649reaching respective pockets 660. Thereafter, the dowel 608 is insertedthrough the pair of openings 670 and through the orifice 624 of thesecond arm 616 to lock the second arm to the second runner. After thedowel 608 is in position, the second runner 606 may not belongitudinally or vertically repositioned with respect to the second arm616. But the second runner 606 may be rotationally repositionable withrespect to the second arm 616 about an axis coaxial with thelongitudinal length of the dowel 608 where the bias of the second pairof ancillary appendages 646 retards rotation of the proximal end of thesecond runner 606.

In operation, the spring 602 operates to bias the runners 604, 606toward one another to exert an occlusion pressure upon tissue capturedtherebetween. To achieve this bias, the spring 602 may be cast, cut, orfabricated in the shape shown in FIG. 35 . Repositioning the first arm614 away from the second arm 616 requires overcoming the bias of thespring 602, principally the bias attributed to the U-shaped end 610.When no active force is exerted upon the arms 614, 616 and the ancillaryappendages 644, 646, the arms and appendages will default to theposition shown in FIG. 33 . Consequently, when positioning the clip 600to occlude bodily tissue, such as a left atrial appendage, the clip 600is forced open so that the distal ends of the arms 614, 616 are forcedfarther away from one another to create a vertical gap between therunners 604, 606. This vertical gap is wide enough to allow bodilytissue to interpose the runners 604, 606 and, when the active force isno longer exerted upon the arms 614, 616 and ancillary appendages 644,646, the bias of the spring 602 is operative to force the runners towardone another and discontinue circulation across the tissue interposingthe runners. Eventually, the absence of circulation to one side of theclamped tissue leads to atrophy and occlusion of the bodily tissue inquestion.

Consistent with the foregoing embodiments, occlusion of the bodilytissue is accomplished through transferal of the forces imparted by thespring 602 through the runners 604, 606 and transmitted to the tissue asa pressure profile. The presence of proximal and distal spring biasallows the occlusion clip runners 604, 606 to balance the forceindependently at the proximal and distal ends, allowing for non-uniformshapes of tissue to be evenly compressed between the runners. Thedesired pressure can be obtained through adjustment of both the springforce and the runners 604, 606 shape and size. The spring force is afunction of the shape, thickness, and width of the spring 602 materialand each can be independently adjusted to obtain the desired force atthe desired separation. Additionally, it is desired that as the tissueatrophies, a significant force continues to be applied even as therunners 604, 606 compress the tissue between them to near zero or zerothickness. This “zero offset force” can be adjusted through design ofthe shape of the spring 602 causing the “free state” of the contactpoints of the spring to the runners 604, 606 to become closer togetheror to even offset in the negative direction. It will be understood bythose with ordinary skill in the art that this offset may be designedinto the spring 602 or may be introduced through intentional plasticdeformation of the spring.

The exemplary occlusion clips may be fabricated from any number ofmaterials including, without limitation, plastics, composites, metals,and ceramics. For example, the exemplary runners and springs may both befabricated from a biologically compatible titanium. By way of furtherexample, the exemplary runners may be fabricated from a biologicallycompatible plastic and the springs fabricated from a biologicallycompatible metal. By way of further example, the runners may befabricated from high density polyethylene and the springs may befabricated from nitinol. Conversely, the exemplary runners may befabricated from any biologically compatible material and the springsfabricated from a biologically compatible material exhibiting sufficientelastic characteristics. By way of further example, the runners may befabricated from titanium and the springs fabricated from stainlesssteel. By way of further example, the runners and springs may befabricated from bioabsorbable materials and/or materials thataccommodate or promote the ingrowth of tissue.

It is also within the scope of the invention for the exemplary occlusionclips to be shrouded in a tissue ingrowth material. For example, theexemplary occlusion clips may be encased in a C-shaped, loop sleeve thatis cylindrical and closed at opposing ends in order to accommodateopening and closing of the exemplary clips (i.e., separation or spacingbetween the runners sufficient to position tissue therebetween). Thoseskilled in the art are familiar with tissue ingrowth materials such asporous fabrics, including knitted, braided, or woven PET yarn orincluding Gore Dualmesh (available from W.L. Gore & Associates,www.gore.com) that may be used to shroud the foregoing exemplaryembodiments.

Following from the above description and invention summaries, it shouldbe apparent to those of ordinary skill in the art that, while themethods and apparatuses herein described constitute exemplaryembodiments of the present invention, it is to be understood that theinventions contained herein are not limited to the above preciseembodiment and that changes may be made without departing from the scopeof the invention as defined by the following proposed points of novelty.Likewise, it is to be understood that it is not necessary to meet any orall of the identified advantages or objects of the invention disclosedherein in order to fall within the scope of the invention, sinceinherent and/or unforeseen advantages of the present invention may existeven though they may not have been explicitly discussed herein.

What is claimed is:
 1. An occlusion clip comprising: a spring; a firstrunner including a first open top, the first runner including a firstinterior camming surface partially delineating a first interior cavitythat is open by way of the first open top; a second runner including asecond open top, the second runner including a second interior cammingsurface partially delineating a second interior cavity that is open byway of the second open top; wherein the spring is configured to becoupled to the first runner and the second runner; wherein the firstinterior cavity is configured to receive a first portion of the spring;wherein the second interior cavity is configured to receive a secondportion of the spring; wherein the first interior camming surface isconfigured to engage a first cam of the spring; and, wherein the secondinterior camming surface is configured to engage a second cam of thespring.
 2. The occlusion clip of claim 1, wherein at least one of thefirst runner and the second runner is pivotally mounted to the spring.3.-10. (canceled)
 11. The occlusion clip of claim 1, wherein: the springembodies a C-shape with a first leg and a second leg; and, at least oneof the first leg and the second leg includes a longitudinal variance.12. The occlusion clip of claim 11, wherein: the first leg and thesecond leg each include a longitudinal variance; and, the longitudinalvariance of the first leg forms a cavity along a longitudinal length ofthe first leg.
 13. The occlusion clip of claim 12, wherein thelongitudinal variance of the second leg forms at least two cavitiesalong a longitudinal length of the first leg.
 14. The occlusion clip ofclaim 13, wherein: the longitudinal variance of the first leg isconfigured to receive a first portion of the repositionable lock tomount the first leg to the first runner; and, the longitudinal varianceof the second leg is configured to receive a second portion and a thirdportion of the repositionable lock to mount the second leg to the secondrunner.
 15. The occlusion clip of claim 14, wherein: the longitudinalvariance of the first leg comprises a first V-shaped notch; thelongitudinal variance of the second leg comprises a second V-shapednotch and a third V-shaped notch; the first portion includes a firstdowel; the second portion includes a second dowel; and, the thirdportion includes a third dowel.
 16. The occlusion clip of claim 1,wherein: the first runner includes an arcuate tissue contacting surface;the second runner includes an arcuate tissue contacting surface; and,the arcuate tissue contacting surface of the first runner faces thearcuate tissue contacting surface of the second runner when the firstand second runners are mounted to the spring. 17.-47. (canceled)
 48. Theocclusion clip of claim 1, further comprising a fabric interposing thefirst and second runners.
 49. (canceled)
 50. An occlusion clampcomprising: a spring comprising at least two elongated legs coupledtogether at a first end and independently repositionable with respect toone another at second, free ends so that the spring is open-ended, thespring having a dominant dimension measured from the first end to one ofthe second ends; a first runner coupled to a first leg of the at leasttwo elongated legs, the first runner comprising an elongated occlusionbeam having an occlusion surface, the first runner having a dominantdimension; a second runner coupled to a second leg of the at least twoelongated legs, the second runner comprising an elongated occlusion beamhaving an occlusion surface, the second runner having a dominantdimension; wherein the spring is configured to bias the occlusionsurface of the first runner toward the occlusion surface of the secondrunner; and, wherein the dominant dimensions of the spring, firstrunner, and the second runner extend in generally the same direction.51. The occlusion clamp of claim 50, wherein: the second, free ends arespaced apart from one another along the dominant dimension of thespring; the first leg is coupled to the first runner at a firstlocation; the second leg is coupled to the second runner at a secondlocation and a third location; and, the first location interposes thesecond and third locations along the dominant dimension.
 52. Theocclusion clamp of claim 51, wherein: the first leg traps a first pin tomount the first leg to the first runner; and, the second leg traps asecond pin and a third pin to mount the second leg to the second runner.53. The occlusion clamp of claim 52, wherein: the first pin is mountedto the first runner; the second pin and the third pin are mounted to thesecond runner; the first leg includes a first discontinuity configuredto receive the first pin so that the first leg interposes the first pinand the first runner to mount the first leg to the first runner; and,the second leg includes a second discontinuity configured to receive thesecond pin and a third discontinuity configured to receive the third pinso that the second leg interposes the second pin and the second runnerand interposes the third pin and the second runner to mount the secondleg to the second runner.
 54. The occlusion clamp of claim 53, wherein:the first discontinuity comprises at least one of a U-shaped segment anda V-shaped segment; the second discontinuity comprises at least one of aU-shaped segment and a V-shaped segment; and, the third discontinuitycomprises at least one of a U-shaped segment and a V-shaped segment. 55.The occlusion clamp of claim 53, wherein: the first discontinuity isreceived within a trench of the first runner; and, the seconddiscontinuity and the third discontinuity are received within a trenchof the second runner.
 56. (canceled)
 57. The occlusion clamp of claim50, wherein: the second, free ends are spaced apart from one anotheralong the dominant dimension of the spring; the first leg is pivotablewith respect to the first runner at a first location; the second leg isengages the second runner at a second location and engages the secondrunner at a third location; and, the first location interposes thesecond and third locations along the dominant dimension.
 58. Theocclusion clamp of claim 57, wherein: a first pin is mounted to thefirst runner; a second pin is mounted to the second runner; the firstleg traps the first pin to mount the first leg to the first runner; and,the second leg traps the second pin to mount the second leg to thesecond runner.
 59. The occlusion clamp of claim 58, wherein: the firstleg includes a first discontinuity configured to receive the first pinso that the first leg interposes the first pin and the first runner tomount the first leg to the first runner; and, the second leg includes asecond discontinuity configured to receive the second pin so that thesecond leg interposes the second pin and the second runner to mount thesecond leg to the second runner.
 60. The occlusion clamp of claim 59,wherein: the first discontinuity comprises at least one of a U-shapedsegment and a V-shaped segment; and, the second discontinuity comprisesat least one of a U-shaped segment and a V-shaped segment.
 61. Theocclusion clamp of claim 59 or 60, wherein: the first discontinuity isreceived within a trench of the first runner; the second discontinuityis received within a trench of the second runner; the second legincludes a third discontinuity that is received within the trench of thesecond runner; and, the third discontinuity occurs at the thirdlocation. 62.-92. (canceled)